Stabilization in early adult-onset myopia with corneal refractive therapy

• Orthokeratology changes the relative peripheral astigmatic components in patients with early-adult onset myopia.
• Despite their ages, the early-adult onset myopes presented in this case series experienced a significant myopia progression before they were treated with orthokeratology.
• After starting orthokeratology treatment these patients showed slower progression or no progression of their refractive error.
• Axial length remained stable during orthokeratology treatment in early-adult onset myopia.

PurposeTo describe the stabilization of early adult-onset myopia in three university students after initiating orthokeratology treatment with corneal refractive therapy contact lenses.MethodsThree Caucasian early adult-onset progressing myopic subjects (1 male, 2 females) were fitted with corneal refractive therapy lenses to correct myopia between −1.50 and −2.50 D of sphere using Paragon CRT (Paragon Vision Sciences, Mesa, AZ) lenses for overnight orthokeratology. The pre-treatment refractive history from 2005 as well as refraction and axial length after treatment onset are reported over a period of 3 years between December 2009 and January 2013 with an additional year of follow-up after treatment discontinuation (January–December 2013). The peripheral refractive patterns and topographic changes are also reported individually.ResultsTreatment was successful in all three subjects achieving uncorrected visual acuity of 20/20 or better monocularly. During a period of 3 years of follow-up the subjects did not experience progression in their refractive error, nor in their axial length (measured during the last 2 years of treatment and 1 year after discontinuation). Furthermore, the subjects recovered to their baseline refraction and did not progressed further over the following year after lens wear discontinuation.ConclusionsWe cannot attribute a causative effect to the orthokeratology treatment alone as underlying mechanism for myopia stabilization in this 3 patients. However, the present report points to the possibility of stabilization of early adult-onset myopia progression in young adults using corneal refractive therapy treatment.